Awareness raising and treatment

Men who have sex with men (MSM) are at an increased risk of HIV infection. The H-TEAM raises awareness among MSM of the importance of seeking HIV testing very soon after having been put at risk, and of starting treatment as soon as possible if an HIV infection is found. By running awareness-raising campaigns, we also raise awareness of symptoms that could indicate an acute HIV infection.

Awareness raising and treatment: the campaigns

To stop the HIV epidemic in Amsterdam, it is important that people know their HIV status and access treatment in time. Some 70 percent of HIV infections in the Netherlands occur among MSM. This group is therefore the focus of the H-TEAM’s awareness-raising activities.

By creating awareness and providing immediate referral trajectories for testing options and treatment, the H-TEAM:

  • Promotes greater awareness of the early symptoms of HIV among MSM
  • Ensures faster detection of acute or chronic HIV in MSM

Through innovative communication campaigns we make MSM aware of the symptoms of an acute HIV infection and the benefits of rapid treatment. Online tools are used to stimulate MSM to seek HIV testing soon after possible exposure to HIV.

Scroll down for more information on these campagnes and their results.

Approach

Through this communication campaign, the H-TEAM has made men who have sex with men (MSM) aware of the symptoms of an acute HIV infection (AHI). The campaign was launched in August 2015 by means of posters, flyers and banners in gay online and offline media. These served as a trigger for the campaign website: hebikhiv.nl – ‘Do I have HIV?’. The website offers information on recognizing an acute HIV infection. Men who have recently been at risk can also complete a Symptoms Check on the site.

Read more about the Symptoms Check

This interactive check raises awareness of risk behaviour and the possible symptoms during the acute phase of an HIV infection. If the Symptoms Check indicates that someone may have an acute HIV infection, he or she will be referred to Public Health Service Amsterdam (PHSA). There is a special procedure that allows people who suspect that they have an acute HIV infection to be tested immediately using a special device that can detect HIV at an early stage. If a person is found to be HIV-positive, he can immediately visit an HIV practitioner in Amsterdam thanks to a special fast-track procedure.

Results

The campaign received national media coverage on August 18th 2015. The campaign has received a boost on two occasions, with online banners on social media and dating sites. Partly because of these boosts, the website hebikhiv.nl/en continues to be visited and used. On May 1st 2018, the website had been visited over 207,490 times and the Symptoms Check had been completed over 117,658 times.

 

Test results as of March 2018:

0
men reported for an AHI test at the PHSA
0
HIV diagnoses were made
0
confirmed as being acute HIV infections

Of the men who presented for an AHI test at PHSA, 38% confirmed that they were directed to PHSA by the campaign or the website. In the first months of the campaign, this rate was 60%. This not only shows that the website is still effective, but also suggests a process of generalization of the knowledge on acute HIV within the risk group and among professionals, as almost two-thirds of referrals are now taking place outside the campaign.

National roll-out of AHI campaign

Following the experiences with the acute HIV infection campaign, the H-TEAM explored if a national roll-out of the AHI diagnostic and referral trajectory would be feasible. The national AHI campaign was launched in November 2019 with a new website: hebikhiv.nl. The campaign was designed and produced together with the community.

Approach

The second campaign was launched nationally in September 2017. This campaign focused on the importance of rapid HIV treatment and rapid testing after people have run the risk of an HIV infection. The campaign aimed to alleviate fears about a positive test result, by emphasizing that having HIV will only have a limited impact on a person’s future life and their sex life.

 

The campaign consisted of three components:

  1. Videos that illustrate day-to-day situations in which MSM may find themselves, where an HIV-positive status and the benefits of treatment are presented in a normative and nonchalant manner. These videos helped to normalize and de-stigmatize HIV infection and its treatment.
  2. The distribution of greeting cards and postcards that conveyed the message that you can live a healthy life with HIV if you start treatment early.
  3. A website – Laatjesneltesten.nl – which offered more detailed information on the benefits of early treatment (cART) and the need for HIV testing as soon as possible after potential exposure. The website provided users with tailored advice on testing through a Risk Check, and linked users with different options for HIV testing according to the region in which they live.

The campaign received national media coverage and the website was visited over 32,000 times. The Risk Check was used over 9,000 times. The advertisements and videos have been viewed over 3 million times (January 1, 2018).

 

A boost of the campaign was launched on April 23rd 2018 to raise awareness of the campaign. The main goal was to achieve views of the videos through YouTube and Bullchat.

Approach

Now that HIV is no longer a deadly illness, but a chronic one, the question arises whether risk groups truly realize the implications of having HIV. For example, if HIV negative MSM underestimate the implications of HIV as a chronic illness, they will be less motivated to actively avoid acquiring the infection by using condoms or PrEP. We therefore wish to investigate whether such knowledge gaps exist, and if they do, to develop an intervention that will correct such beliefs and strengthen the motivation of MSM to avoid acquiring an HIV infection.

 

This campaign consists of two steps:

 

  • Step 1:

For the first study, a qualitative study was carried out of the experienced consequences of HIV diagnosis and its perceived burden among MSM diagnosed as of 2014. The second study examined the perceived burden of HIV as a chronic illness among HIV negative MSM and the experienced burden of HIV as a chronic illness among HIV positive MSM.

 

  • Step 2:

Based on findings from the first study, the H-TEAM will devise an HIV prevention intervention. The campaign will consist of a tailored intervention to counteract knowledge deficits and problematic perceptions regarding HIV as a chronic illness among HIV negative MSM. In this way we hope to improve the basic motivation to undertake protective measures to avoid acquiring an HIV infection.

Results

The qualitative part of the first study was concluded. We conducted 18 interviews among MSM with HIV diagnosed between 2014-2018. Results indicated that after a habituation period, several aspects of HIV infection remained burdensome among recently HIV infected MSM. These were primarily related to stigma and social experiences, next to some aspects relating to the treatment itself.

 

The quantitative part of the first study has been concluded as well. Based on themes that emerged from the qualitative investigation, two adapted questionnaires were constructed: one to measure burden among HIV positive men, and one to measure perceived burden among HIV negative men. The questionnaires were advertised online in gay social media and dating apps during the month of May and June. In total, 3325 questionnaires were filled in. The results are currently being analyzed.

Team

  • Arjan van Bijnen
    Arjan van Bijnen

    Member
    Soa Aids Nederland

  • Godelieve de Bree
    Godelieve de Bree

    Member
    Amsterdam UMC
    AIGHD

  • Udi Davidovich
    Udi Davidovich

    Project Leader
    GGD Amsterdam

  • Wim Zuilhof
    Wim Zuilhof

    Project Leader
    Soa Aids Nederland

  • Tomas Derckx
    Tomas Derckx

    Member
    Hiv Vereniging Nederland